In most European countries around half of the population is now overweight or obese, and the percentage is set to rise further over the next decade. In the UK this could reach 71% by 2025

Associated healthcare costs are rising, with direct costs ranging from 1.5-4.6% of health expenditure in France to around 7% of healthcare spending in Spain

Lifestyle and behavioural education programmes are crucial—but obesity is also a medical condition that is hard to treat and is directly linked to other serious conditions

No European country has a comprehensive strategy for dealing with obesity. Experts say that only an integrated, multi-sectoral strategy is likely to cap the growth of obesity rates

Europe is facing an obesity crisis of epidemic proportions that threatens to place a tremendous burden on its healthcare systems. But policymakers appear divided over how to deal with the issue, according to Confronting obesity in Europe: Taking action to change the default setting, a new white paper published today (November 25th) by The Economist Intelligence Unit (EIU) and sponsored by Ethicon.

Projections from the World Health Organisation (WHO) indicate that the proportion of those who are overweight or obese is expected to rise further in most of western Europe over the next decade, reaching 71% in the UK, 76% in Iceland and 82% in Ireland, although the projections remain cautious owing to limitations in available data and reporting. Obesity puts strains on healthcare systems: the European Organisation for the Study of Obesity (EASO) found direct costs ranging from 1.5-4.6% of health expenditure in France to around 7% of healthcare spending in Spain.

Several of those interviewed for the report agree that European obesity policy on the national level has suffered from being fragmented among a number of government agencies, creating the need for better integration. "An effective strategy has to integrate a number of different sectors and different tools", said Roberto Bertollini, chief scientist and WHO representative to the EU.

Most policies looking to address obesity focus on lifestyle changes, including an emphasis on healthy diets and exercise. The majority of pan-European and even national obesity campaigns have been focused on healthy eating in schools and homes, better food labelling and incentives associated with healthy eating and exhortations for work-outs or “active kids” campaigns.

While lifestyle and behavioural education programmes have a crucial role to play in preventing obesity in healthy people, experts (including the American Medical Association) define obesity as a disease that is hard to treat. In order to rise to the challenge of obesity, policymakers need to acknowledge that those who are already obese are suffering from a medical condition for which lifestyle-based programmes are insufficient.

Zoe Griffith, head of programme and public health at Weight Watchers, highlighted the limitations of programmes aimed at lifestyle and behavioural change: "Education in schools, availability of healthy eating and restriction on marketing to children will go some way towards resetting our society, but what they are completely ignoring is the majority of the population who are overweight and obese and need treatment. It’s a very complex political and policymaking environment."

Martin Koehring, the editor of the report, summarised the report findings as follows: “Our report has highlighted that creating an environment that prevents obesity and discourages an unhealthy lifestyle is crucial. National approaches to obesity need to take into account two very different target populations. On the one side are healthy people, for whom prevention programmes are largely designed. On the other side are those who are already severely overweight and obese, for whom the traditional emphasis on behavioural change is generally ineffective. Only an integrated, multi-sectoral strategy is likely to cap the growth of obesity rates.”